| NPI | 1811946668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101047478) |
| Additional Taxonomies | 207WX0110X Ophthalmology Pediatric Ophthalmology and Strabismus Specialist (Licence: VA 0101047478) |
| 207W00000X Ophthalmology (Licence: VA 0101047478) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2019-07-10 |